腭裂手术技巧探讨  

The study of some surgical skills for cleft palate repair

作　　者：杨寿康[1] 孙国良[1] 张号[1] 

机构地区：[1]郴州市第一人民医院口腔科

出　　处：《中国临床新医学》2009年第1期51-53,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨腭裂修复术的手术技巧及临床应用。方法回顾168例腭裂患者的修复手术，对手术方法的选择、电刀的使用、切口的顺序、粘骨膜瓣的剥离及松驰、无创可吸收缝线的使用、牙槽突及前腭部的处理、鼻腔粘膜的封闭、悬雍垂的处理、腭帆张肌解剖及功能重建和松弛切口的处理等应用的一些手术技巧进行临床效果总结分析。结果168例腭裂患者术后除有3例在硬腭前份牙槽突裂隙处并发穿孔，1例在软腭部发生穿孔外，其余患者均获得良好愈合，悬雍垂形成良好，软腭活动度满意。结论在手术过程中运用一些技巧和使用一些特殊器材有利于缩短手术时间、减少出血、减少缝合张力、减轻组织水肿、避免穿孔和复裂；有利于悬雍垂形成；有利于腭部解剖结构和生理功能的恢复和提高手术的成功率。Objective To discuss some skills concerning the operation for cleft palate and clinical applications of these skills. Methods Retrospecting 168 cases of surgical operations for cleft palate repair, some surgical skills for cleft palate, including selection of operative methods, usage of electrotome, sequence of incisions, stripping and slacking of mucoperiosteal flap, usage of noninvasive absorbable surgical sutures, dealing of alveolar ridge and anterior palate, closure of mucous membrane in the nasal cavity, dealing of uvula, anatomy and function reconstruction of levator veli palatine, and filling up of the flabby wounds, were evaluated. A clinical analysis was made for the outcome. Results All of 168 cases but four have got excellent healing, with good shape of uvula and satisfactory activity of soft palate. Perforation occurred in alveolar cleft in three cases and one in soft palate. Conclusion The application of certain skills for cleft palate surgery is helpful to shorten operation time, decrease bleeding during the operation, reduce suture tension, alleviate tissue edema, avoid perforation and rupture , figure uvula, restore anatomic structure and physiologic function of palate, promote wound healing, and improve the succession rate of operation.

关 键 词：腭裂修复术 手术技巧 

分 类 号：R782.22[医药卫生—口腔医学]